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Nursing Week: The perils of a part-time profession

Wonky working hours only one of the problems associated with the “stacking” of part-time jobs in the health-care sector to try and make up a full-time paycheque.

Nurse Kriste Bilodeau checks vital signs of patient Bernice DeMille, 87, at the Prince Edward County memorial Hospital in Picton, one of many Ontario hospitals where budget cuts are changing the nursing world.
(Paul Dalby / for Toronto Star)

By Paul DalbySpecial to the Star

Thu., May 15, 2014

For 20 years Lisa Plante drove an 18-wheeler along the highways of Ontario. Now she steers four wheels on a med-cart at a long-term care facility. Two years ago she made the quick lane change from truck driver to registered practical nurse and swapped a full-time gig for a part-time existence.

Plante, 48, of Port Colborne, Ont., emerged from nursing school as a qualified RPN in spring 2011, only to find that, like 20,000 other nurses in Ontario, a full-time job was a pipe dream.

Plante loves her job and her patients, but finds the wonky working hours generated by two separate part-time jobs in health-care facilities 20 kilometres apart often gruelling.

“There are times when I will work a midnight shift at the hospital in Welland, get off at six o’clock in the morning, come home for a shower and then go out again and work a day shift at the extended-care facility,” Plante said. “Many times I have run out the door even when we have made plans because I can’t afford to work only one or two shifts a week.”

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Plante’s topsy-turvy life is fast becoming the norm rather than the exception in Ontario’s health-care system. Ontario’s hospitals, nursing homes and long-term care facilities, handcuffed by a provincial budget freeze, are replacing more full-time nursing jobs (usually RNs with seniority pay scales, overtime and paid benefits) with lower paid part-time RPNs (receiving few or no benefits).

Hospital administrators believe using part-timers gives them more scheduling flexibility and saves them money. On average, an RN earns between $28-$40 an hour, while an RPN is paid between $18 and $27 an hour.

But nursing leaders are worried that the practice is producing a culture of “rental” nurses.

On the hospital wards, it’s known as “stacking” — working at as many as three jobs every week to make up a full-time paycheque.

“I worked part-time for 10 years waiting to get a full-time job and I know what it’s like to stack part-time jobs to make a living,” said Dianne Martin, a veteran nurse with both RN and RPN qualifications. “Scheduling is a nightmare because we work shiftwork and you end up working every weekend and every holiday. You never have Christmas with your family.”

“There are two impacts from having a nurse working part-time. One is to the patient and one is to the nurse,” said Martin, with 26 years’ bedside experience as both an RPN and RN.

“Two part-time nurses do not make a full-time nurse. We know that patients have better outcomes when there is a consistency in nursing, and the nurse gets to know the patient’s story and uniqueness,” said Martin, whose own daughter is a nurse now working part-time hours. “And anytime you make a nurse’s life very difficult, that also impacts her profession.”

Studies have shown that care provided by experienced, well-trained, full-time nurses reduces patient mortality, shortens the length of hospital stays, and reduces the number of patients returning to hospital with complications. Patients also feel happier and more satisfied with their treatment.

Martin says that nursing is a holistic profession and part-time shifts only ramp up the stress level for nurses, who work longer hours for less money and suffer from greater fatigue and illness.

A recent study commissioned by the Canadian Federation of Nursing Unions found nurses had an absenteeism rate due to illness or disability almost double the rate for all other occupations in the workplace.

Martin says any increase in hiring part-time nurses will also have long-term ramifications for the nursing profession.

“We don’t have any trouble recruiting into the profession. Our problem is keeping people in the profession,” Martin said. “Last year our strength dropped a full four per cent. That’s a really significant drop.”

“If you are a new graduate nurse, what are your prospects of getting a full-time job? I’m going to say it’s next to none. Going into a profession where that is the reality, it’s going to be hard,” said Martin.

It’s a sentiment echoed by Dr. Kirsten Woodard, dean of the School of Nursing at Peterborough’s Trent University: “I try to be very honest with students in our recruiting sessions. I think there is a very good chance of them getting a job at the end of a four-year . . . degree, but I can make no promises. These are certainly interesting times.”

Trent’s nursing school enrolls 270 students a year in its three programs, but routinely turns away another 2,000 applicants. Even with the uncertainty about landing a full-time job, nursing continues to be a very attractive option.

But Woodard, president-elect of the Canadian Association of Schools of Nursing, says the budget cutbacks in hospitals and other health-care facilities are also having a marked effect on nursing schools across the province by actually limiting each school’s intake.

“The tighter hospital budgets get, they just don’t have as many people who can act as preceptors for our students, and because they feel more stress on their units, it has an effect on morale. It lowers their desire to take on these students,” she said.

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